National Mediclaim Policy

National Insurance Mediclaim Policy is designed to offer financial comfort to the insured at the time of a medical emergency. It looks after in-patient hospitalization (minimum 24 hours) expenses and 140+ day care procedures on a reimbursement/cashless basis. With this policy, you can be rest assured that your medical expenses are well-cared after.

National Insurance Mediclaim Policy Details

**Last Updated on 28-01-2021

Benefits of Buying The National Mediclaim Policy?

National Mediclaim Policy comes with a lot of useful benefits, which the insured person can avail of to tackle a medical emergency. Let's take a look at it.

1. In-Patient Hospitalization

   Expenses incurred against room rent/ICU charges, medical practitioner, anesthetist, surgeon's fees, etc. are looked after by the policy up to the specified limits.

2. Modern Treatments

   To offer a complete package, the policy covers the expenses of 12 treatments like immunotherapies, oral chemotherapies, robotic surgery, among others.

3. Alternate Treatments

   If the insured person wishes to avail of treatment under Allopathy, Ayurveda, and Homeopathy, the plan will cover its expenses (up to 100% of SI).

4. Ambulance Expenses

   If a situation arises when the insured needs to be taken to the hospital via an ambulance, its expenses will be covered (up to 1% of SI, maximum Rs.2000) under the policy.

5. Sum Insured Reinstatement

   If the insured person (having SI of 6 lakhs & above) finishes off his SI on account of hospitalization claims, the company is liable to reinstate his base SI (according to its conditions).

6. Preventive Health-Checkups

   If the insured person doesn't claim in 4 continuous policy years, the policy will pay for his health-check-up/prescribed diagnostic tests (up to 1% of average basic SI, maximum Rs.5000).

7. Co-Pay Discount

   The company grants a discount on choosing co-pay options. On 20% co-payment, 15% off is given on the total premium. And on 15% co-payment, 10% off is given on total premium.

8. Cumulative Bonus

   In the case of every claim-free year, the insured can earn a cumulative bonus of 5% of the basic SI of the expiring policy.

9. Special Offers

   The policy covers the treatment expenses of certain illnesses like morbid obesity and correction of eyesight (refractive errors above -7.5 D) after their waiting period is over.

Why Is It A Good Idea To Invest In National Mediclaim Policy?

Manik, a 32-year old interior designer, has a family history of mental illness. He has seen first-hand how his mother suffered from mental illness, both physically and financially. To save his savings, he decides to purchase National Mediclaim Policy.

After 4 years, Manik's wife starts to notice symptoms of mental illness and advises him to go for a medical check-up. When the results are out, Manik is diagnosed with the 1st stage of mental illness and has to go through regular treatment. With the support of the National Mediclaim Policy, Manik's family doesn't have to worry about medical expenses and Manik can get the best treatment at hand.

What's Not Covered Under National Mediclaim Policy?

Though National Mediclaim Policy promises comprehensive coverage, there are a few conditions/situations that it doesn't cover. Let's learn about them.

To know more about them, please check the policy brochure.

How Can You Invest In National Mediclaim Policy?

Thanks to the easy navigation and user interface of the National Insurance's website, you can buy this policy from it in no time. Let's learn about its buying process.

In case you don't wish to purchase via National Insurance, you can place your trust in PolicyX.com.

How To Claim Against National Mediclaim Policy?

National Insurance advises its customers to follow the below-listed process for successful claims. Let's check it out.

1. Cashless Claim

   • This is only possible if treatment is availed in a cashless hospital partnered with National Insurance. For planned hospitalization, inform the company/TPA 72 hours before. In case of emergency hospitalization, the notification must be sent within 24 hours of admission.
   • The hospital will send the pre-authorization form to the TPA with the necessary details.
   • Pre and post-hospitalization expenses can be claimed (separately) after the treatment.
   • After completion of post-hospitalization treatment, the insured has to submit all required documents (in original) within 15 days to TPA.

2. Reimbursement Claim

   • If the insured wants to undergo the treatment in a non-network hospital, he needs to inform the company/TPA within 72 hours (for emergency hospitalization) and before 72 hours (for planned hospitalization).
   • On discharge, collect all the necessary documents and submit the same to TPA within 15 days.
   • Once the verification is done, the company will transfer the claim amount to the registered bank account.

3. Documents Required

   • Duly filled claim form.
   • Original bills, medical history of the patient recorded, discharge certificate/ summary from the hospital, etc.
   • Original cash-memo from the hospital (s)/chemist (s), supported by proper prescription
   • Attending medical practitioner's certificate regarding diagnosis and bill receipts, etc.
   • Surgeon's original certificate stating diagnosis and nature of operation performed along with bills/receipts, etc.
   • Others requested by the company.